Camp DoReMi 2019  *  August 15-18, 2019
Wildacres Retreat  *  Little Switzerland, North Carolina

Please print this form and fill out separate forms for each registrant. Make check payable to Camp DoReMi.
Mail form and payment to Jane Cannon, Camp DoReMi, 313 Wasena Lane, Rutherfordton NC 28139.



                                                                     Age:                     Gender:                                 Phone#:                                                  E-mail:

                                                                     Emergency Contact (include name & phone #):

                                                                     Name of Parent or Guardian that will accompany this participant if under 18:

                                                                    ______ Full Participant - $300 - Includes double occupancy with bath at Wildacres Retreat  for three nights, 8 meals, gratuities and classes  
                                                                    ______ Commuter - $60 / day - Includes classes and 3 meals per day.  

                                                                  Roommate Preference (if you do not specify, one of your gender will be assigned for you):

                                                                 Camp Mailing List: Would you like your e-mail address to be included in a list of participants available only to Camp DoReMi?

                                                                 Books you will bring to Camp:  (Circle the ones you'll bring)   The Christian Harmony, 2010 Ed.      The New Harp of Columbia

                                                                  SPECIAL NEEDS: (for example, difficulty climbing stairs or dietary restrictions)